Organizational access points and substance use disorder treatment utilization among Black women: a longitudinal cohort study

Sugy Choi, Amanda Bunting, Talia Nadel, Charles J. Neighbors, Carrie B. Oser

Research output: Contribution to journalArticlepeer-review


Introduction: Health and social service organizations, including the emergency department (ED) and public assistance programs, constitute a social safety net that may serve as an “access point” for substance use treatment utilization. Racialization of substance use disorder (SUD) and gender disparities in access to treatment contribute to differences in health and social service utilization, including substance use treatment for Black women. We therefore explored the role of various access points in facilitating the use of substance use treatment among Black women with substance use and involvement in the criminal justice system. Methods: We used data from the Black Women in the Study of Epidemics (B-WISE) project (2008–2011), which recruited Black women who use drugs from community, probation, and prison recruitment settings in Kentucky. B-WISE is a three-wave panel survey collected on a six-month interval. We estimated dynamic panel models to understand whether time-varying use of services influenced women’s substance use treatment utilization over 18-months, adjusting for time-invariant characteristics. We stratified the analysis based on where women were recruited (i.e., community, prison, and probation). Results: The sample included 310 persons and 930 person-waves. For the community and prison samples, the use of an ED in the 6 months prior decreased women’s likelihood of subsequent substance use treatment use (Coef: -0.21 (95% CI: -0.40, -0.01); -0.33 (95% CI: -0.60, -0.06), respectively). For the probation sample, receiving support from public assistance (i.e., food stamps, housing, cash assistance) increased the likelihood of subsequent substance use treatment use (0.27 (95% CI: 0.08, 0.46)). Conclusion: Interactions with health and social service organizations predicted Black women’s use of substance use treatment services and varied based on their involvement in the criminal justice system. Public assistance venues for Black women on probation may be a point of intervention to increase their access to and use of substance use treatment.

Original languageEnglish
Article number31
JournalHealth and Justice
Issue number1
StatePublished - Dec 2023

Bibliographical note

Funding Information:
We would like to thank the participants in the BWISE study as well as the Kentucky Department of Corrections for their collaboration.

Funding Information:
This work was supported by NIDA R01DA48876 and R25DA037190. The contents of this publication are solely the responsibility of the authors and do not represent the official views of NIDA or the Kentucky Department of Corrections.

Publisher Copyright:
© 2023, Springer-Verlag GmbH Germany, part of Springer Nature.


  • Criminal justice system
  • Health disparities
  • Longitudinal analysis
  • Substance use disorder
  • Touchpoints

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Law


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